OFFICE OF THE EMPLOYER ADVISER
EMPLOYERS' COUNCIL ON WORKERS' COMPENSATION
CONTENTS
Wednesday 29 May 1991
Workers' Compensation Board
Office of the Employer Adviser
Employers' Council on Workers' Compensation
Ontario Federation of Labour
Union of Injured Workers
Office of the Worker Adviser
Adjournment
STANDING COMMITTEE ON RESOURCES DEVELOPMENT
Chair: Kormos, Peter (Welland-Thorold NDP)
Vice-Chair: Waters, Daniel (Muskoka-Georgian Bay NDP)
Arnott, Ted (Wellington PC)
Cleary, John C. (Cornwall L)
Dadamo, George (Windsor-Sandwich NDP)
Huget, Bob (Sarnia NDP)
Jordan, Leo (Lanark-Renfrew PC)
Klopp, Paul (Huron NDP)
Murdock, Sharon (Sudbury NDP)
Offer, Steven (Mississauga North L)
Ramsay, David (Timiskaming L)
Wood, Len (Cochrane North NDP)
Clerk pro tem: Manikel, Tannis
Staff: Luski, Lorraine, Research Officer, Legislative Research Service
The committee met at 1533 in committee room 1.
WORKERS' COMPENSATION BOARD
Consideration of the designated matter, pursuant to standing order 123, relating to the Workers' Compensation Board.
The Chair: Perhaps we can start. We are already a couple of minutes behind time. Good afternoon. I will be asking you of course to identify yourselves, but I want to simply indicate at the very beginning this afternoon that this series of meetings with groups and individuals like yourselves is in response to a member's initiative to have this committee consider the following: A review of the procedures of the Workers' Compensation Board which impede the provision of efficient services to workers and employers. In view of the fact that a limited amount of time is being devoted to it, necessarily so because of the rules which give life to it, it is going to be necessary to confine ourselves to that scope as best possible.
I would first ask you if you could identify yourselves, tell us who you are, and then spend perhaps 10 or 15 minutes saying what you would like to say, after which we will devote an equal amount of time to having people here ask questions of you.
OFFICE OF THE EMPLOYER ADVISER
Mr Stutz: Thank you, Mr Chairman. I am Jeffrey Stutz. I am acting director of the office of the employer adviser, which is a branch of the Ministry of Labour. I am joined today on my right by Tom Carroll, acting regional manager, and by Sean Ford, policy analyst in the office.
I should mention that I took up my responsibilities on an acting basis just three weeks ago on assignment from Small Business Ontario, which is a branch of the Ministry of Industry, Trade and Technology. I managed the advocacy program there on behalf of Ontario's small businesses and also worked on program delivery in the field of entrepreneurship, education and small business programs such as the new ventures loan program. So while I have some direct experience of workers' compensation, I have Mr Carroll and Mr Ford here as resources in the event that your questions get into more technical areas with which I may not yet be familiar.
I do think my experience in small business will be relevant to the committee's interests because I have had some direct contact with individual business owners and know the difficulty they experience in dealing generally with departments of government. There are probably more than 20 ministries and agencies of the Ontario government with which a new small business owner has to deal, and it is by no means the workers' compensation system alone that the small business owner finds confusing. So we may want to get into that area of simplifying access to government through this whole maze of services of which workers' compensation is one important part.
I was also responsible for our customer service strategy in the small business field over the past year, and this is part of the flavour of our presentation. The last pages of our brief deal with the need to establish a broad customer service strategy in the Workers' Compensation Board, something which I think we have seen successfully in other parts of the government.
Let me say a word of introduction about the office of the employer adviser. It was founded five years ago by Bill 101 in tandem with the office of the worker adviser essentially to help employers and especially smaller companies deal with the workers' compensation system.
It has three types of assistance really. One is training, a kind of preventive role in which we try to familiarize the owners and staff of companies with the ins and outs of the system: how to manage their claims, how to see through appeals, how to make sure they are fairly treated in the premium payment system of the board.
Second, we will represent businesses, particularly again trying to devote our time to smaller companies as they appeal claims made by their employees which they may consider questionable, in order to keep their costs down. So we will advise them or actually accompany them to hearings or in preparing their objections to claims in the system. Over recent years, we have done 800 to 1,200 of these claims representations per year and about 300 appearances at hearings.
Finally, we play a role in the development of legislation and in the development of administrative policy at the board. We prepare briefs; we consult with the employer community and try to advise both the government and the board on what will be workable and what is in the interest of the employers as an important stakeholder in the workers' compensation system.
I think we are in a position to comment on the obstacles as well as the achievements in customer service at the board, both from our own direct experience as employer advisers dealing every day with adjudicators and others in the workers' compensation system, and also from what we hear from the employers as individual companies and associations with whom we are working day in and day out.
I should mention that the office of the employer adviser appeared before this committee three years ago. I guess the committee was reviewing the annual report of the Workers' Compensation Board, and the office made a number of proposals on customer service at that time as well.
Today I would divide my presentation much as the brief is divided, into three parts: first, our general perspective on how the Workers' Compensation Board is performing as a customer service organization; second, how the board could move towards an effective strategy of customer service; and third, the specific recommendations which could be undertaken in the short run to address the needs of employers more effectively.
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First, as our general perspective, I think all of us can recognize that the board is an organization still in a state of very rapid change and evolution. It has absorbed several waves of new technology -- the computer imaging of its filing system, the introduction of voice mail and electronic mail -- and very major organizational changes, a serious effort to push decision-making down to the regional level with the establishment of integrated service units. I think we would say from our own experience and that of the employer community that this adjustment, while painful, has started to pay off in results. It is probably correct on the whole to say that service is somewhat better than it was two or three years ago.
At the same time, it is probably not as good as it could be. Our diagnosis of that is that perhaps not enough attention has been paid to the human side of improving service. So the reservoir of skill and knowledge that is in the staff of the Workers' Compensation Board may not have been fully mobilized. The effect of introducing rapid organizational change and technological change in an organization when the people who work there have not been fully involved and reassured can sometimes be pretty frustrating. I think this has been one of the barriers to really making effective service an ideal and an ethic that works in practice at the board, despite very good intentions and significant investments of time and effort.
Nevertheless, there have been some real achievements. I have mentioned the effort to regionalize decision-making, the introduction of a new workers' benefit payment system, the rehabilitation efforts to contract out now to more than 100 clinics and in fact the establishment of a better process for policy consultation very recently at the board. These are all moves in directions that deserve support and recognition.
Considering the big picture, though, I think it is fair to say that what we have seen is an investment in new equipment, technology and organizational change but not what one could say amounts to a comprehensive strategy. This is one of the recommendations we are making. I think you will hear it again from some of the employer groups. There is a need to step back and do a systematic assessment, what we call an operational review, of the service performance of the board. This is not an end in itself, but it is a way of getting a good, factual and objective view of how the board is doing.
What we present today and what other interest groups will present is certainly based on real experience, but it is bound to be anecdotal. You are going to get stories of individual experiences, hundreds of them perhaps, but not the same thing as an organization which is taking on to itself the job of becoming a better servant of the public.
So we put forward the idea of an operational review of service as the first step in creating a real strategy that the board itself and all its employees buy into. Buying into the service ethic -- I think that is where perhaps this committee could play a leadership role in moving from criticism and identifying procedures that stand in the way of improvement to a real commitment to serve all of the stakeholders better.
I would say that we have in the brief identified half a dozen areas where specific short-term improvements could be made. These are things that are really irritating to employers and irritating to members of my staff when they try to deal with the workers' compensation system. They are very basic things.
In the first section of the brief we talk about service over the telephone. The voice mail system, the answering machine system installed at the board, is turning out to be a barrier to communication. People cannot talk to a human being these days. Normally when you call, your message is recorded and you will probably hear back within two to four days. That is probably not good enough for many employers, and it is fairly frustrating for members of my staff as well. So we think that telephone service policy needs to be looked at.
Similarly, in the area of correspondence there can be very significant time lags in responding. We have set out in the last two pages of the brief our own experience from the offices, setting out how long it takes to get an answer to a phone call, an answer to a letter. We think that although the board has moved to set standards in those areas, the performance is lagging and not meeting those standards.
Some of the other areas which we identify are the revenue system, how premiums and rates are assessed on employers and what happens when they move to appeal; the work processes at the board and the adjudication of claims; and some opportunity to simplify the stages of appeal, perhaps as we suggest by eliminating one whole stage, the decision review branch. As you can see from our table, this last item appears to amount to a three-month stage in a total of an 11-month process of appeal if things go to the hearing stage. Finally, we set out some proposals on improving communications with employers to keep not just employers but all stakeholders well informed about where their file is and what is happening in the processing of a case.
That concludes my presentation. I would be happy to take questions on any aspect of it.
The Chair: Thank you. We will start with the members to my right and one to my left. Five minutes.
Ms S. Murdock: You said that overall service has improved, but I am just wondering if that is seen regionally as well. Are there particular areas that are of concern? For example, I went on the tour of the integrated service unit here, where there is an imaging unit on almost every desk. That was the pilot project, and admittedly in that area there were fewer complaints than there were in other areas. I was wondering if you found that as well.
Mr Carroll: I think it is our understanding that the service is fairly inconsistent. I think generally the regions have been reporting to us that there is improvement. Some regions are able to reach a good communications status with the WCB, and the differences over the last three or four to six months have been condensing. In other words, people are saying that -- for example, Windsor is improving for us. We have gone down and met with the people; we have taken the initiatives. What would have taken a week to get a reply to is now condensing to two days, and in fact I think our Windsor people now are fairly happy.
It has taken initiatives from each regional office to do that. There was at one time quite a difference. There might be a week or ten days before a reply. But you need that kind of strategy with the board to condense those times. We can concentrate on that because that is our business. It is much more difficult if you are an individual person to get that kind of reaction.
Ms S. Murdock: You have also recommended an operational review. Who would you recommend to do that?
Mr Stutz: Our view on that was that it should be done by the board itself. You may hear from other groups that an external organization could be invited to do it, and that certainly is a method that other organizations have followed. But the sense of our organization was to build internal commitment to this process, and therefore it seemed to us the way to go was to ask the board to do it with its own resources.
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Mr Waters: I looked at your survey at the back, appendix 2, where you have total time elapsed and you go to 11.75 months. Obviously you feel that is too long. Representing employers, how long do you feel it should take to run a case through this system?
Mr Stutz: I am not sure we know what ideal is achievable. Our approach was to say that there is approximately a three-month block in there related to the decision review branch that we felt was in many cases unnecessary. At the minimum, one could say, we should be able to take that down to something in the range of eight months. I mean, this is a complex decision-making process. I do not think it can be overnight but I think there are lags in here that one could work on. Perhaps as an ideal to work towards, one could say a six-month process.
Mr Waters: With the decision review branch, you said a couple of times that you feel it should just be eliminated. In here I do not see anything on it. Could you give me some idea as to how often there is a claim decided at that step? Do you have any information on that?
Mr Stutz: The reference to decision review is at the top of page 7 in the brief.
Mr Waters: I was just wondering, because you are saying that it should be done away with, is there never anything resolved at that step or is it so infrequent that it just does not --
Mr Carroll: I think our position is that this is a paper appeal from an adjudicator. The adjudicator writes a decision, hopefully on the evidence, and it is a well-reasoned one. An appeal from that goes to what is really a higher adjudicator, which is decision review. They do a paper look at what that adjudicator has done, sometimes sending it back to the adjudicator to look at again or they make a decision there themselves. Then that is appealable, of course, on to a hearing at the WCB, which is then appealable on to the tribunal. We do not have the tribunal time, but you are looking at maybe six months to another year to complete the process. You may be looking at two years or longer.
We are looking at condensing that, at least from an employer's point of view -- our appeals, employers' appeals -- at least shortening that down. I think noticeable in there is that the access is three to four months. If that could be shortened to a month, we would be looking at four or five months. I do not know. When the system gets clogged and we are not getting the appeals through and people have to wait -- I mean, we are talking about a simple appeal here. Maybe just no one is getting justice. We are looking, at least from an employer's point of view, at shortening that and taking out one of the steps.
Mr Offer: Thank you for your presentation. I will preface my question by apologizing. As I run through this, I hope this is not going to be too rambling a question. It is in a number of parts.
The first part I would ask is, have you taken a look at the breakdown of the businesses that are asking or requiring your assistance in terms of their size and what not? You might want to share that with us.
The second point or observation I wish to make is that you have in your appendix 2 indicated the time frame to deal with a particular matter. I see that it runs from basically 9 to 11 months or so. I imagine that is not a question which deals specifically with the system exclusively but also with your workload in terms of being able to meet the number of concerns brought to your attention.
I am wondering if you might want to respond to those, because they might result in some further questions.
Mr Stutz: Let me comment first on your question about size of company. These statistics have not been kept systematically, but at various times in the past the office has surveyed companies to find out the size distribution. My impression of those results is that probably the average employment size of clients of the office would fall in the range of 50 to 100. Despite the desire to serve many smaller companies, it is the larger companies, with more employees who are more likely to have claims, which are aware of the service and are utilizing it.
Second, the time elapsed here has nothing to do with the workload in our office. I think it is fair to say that there is really no lag in our service. We are tracking along at the speed at which the compensation system copes with cases.
Mr Offer: Okay. So this particular appendix 2 is really a commentary on the system as a whole, giving us a bird's-eye view and potentially how it might be able to be improved?
Mr Stutz: Right.
Mr Offer: In appendix 1, I am just going to be asking you to take me through Sudbury, for instance. "Telephone and Letters." Is that a telephone call or letter to your office, received by answering machine, responded to and appeal letter response time? I am just wondering if you could take me right through that chart.
Mr Stutz: I am sorry if the table is not clear. It is the experience of our staff in calling or writing to the Workers' Compensation Board on behalf of an employer. This is from us, as if we were a client of the workers' compensation system. It means in Sudbury, when we call the WCB office there, do we get an answering machine? Yes, we do. When we call them, how long does it take for the WCB in Sudbury to respond? Two to three days. And so on across the table.
Mr Offer: I might just want to think about that. If there is any time left over and something comes to mind, I will see if I can ask another question.
Mr Arnott: Mr Stutz, I would like to compliment you on your presentation, which has a lot of very good points. Certainly the remark about encouraging the Workers' Compensation Board to buy into the service ethic, I think, is something that could be well received by everyone in Ontario if that were to come about from this exercise.
I would like to describe the typical complaint that I get from small businesses in my riding in Wellington county. Typically it will be a small business from Mount Forest, Fergus or Erin and it is a complaint over the assessment that has been generated. It is a dispute over the accounting figures, the amount of money that the board wants for the assessment. It is quite simple to resolve generally if we get the employer speaking to a senior enough person at the board. Do you have any suggestions about how the assessment system might be simplified to eliminate that problem?
Mr Stutz: Yes, and there is some reference to that on page 4 of the brief. In essence, our ideas there are to get those senior people, the people who deal a lot with revenue matters, to work on them and not perhaps rely on the same adjudicators or hearing officers who deal a lot with claims. I think your observation on the cases that are coming to your office is correct and matches our experience. If we could break away the revenue items which are mainly of concern to the employers and have perhaps peripheral impact on worker concerns, if for the most part those could be in a separate what we call fast-track stream, the employers could get better service than they do today.
Ms S. Murdock: Just on Mr Arnott's question, one of the complaints I have been getting from employers is the form of assessment, in that it is not delineated. Have you had that same experience?
Mr Stutz: I will have to ask Mr Carroll to respond to that. I am not familiar with it.
Mr Carroll: Yes. Almost all assessment forms that come from the board seem very difficult for employers to understand and work with. I think we probably need a committee of employers to come forward to assessment revenue and plot out some forms that are more understandable for them and easier to work with. It seems that minor glitches and minor penalties and things like that are very difficult to remove within the system and are very annoying, and response times are, as in adjudication, very slow. We end up writing a great many letters on a minor point. It certainly impacts on how employers look at the board's efficiency. It is the only department they have to really talk to. You are correct, I think. It is again a matter of form, and I think working more with employers, especially small businesses, you can learn to work with them and understand the system.
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The Chair: On page 5 of the report, under "Work Processes, Staffing and Training," you indicate that file loads for adjudicators are reported to be as high as 300. I have been asked whether that means 300 per and whether they are active. Could you elaborate on that, please?
Mr Stutz: Yes, it means 300 or more live files, active files, per adjudicator.
The Chair: At any given point in time.
Mr Stutz: Yes, that is my understanding. That may be a low number.
Mr Ford would like to add a comment on the decision review branch, the earlier question, if time permits.
The Chair: Sure.
Mr Ford: Coming back to Mr Waters's question, our position has clearly been consistently to take the senior most experienced, most knowledgeable, most able people, who are usually the decision review specialists, and put them at the front, as opposed to putting those with less experience at the front who may have difficulty in making decisions. Then the most seasoned staff can render decisions on file, especially those that may be complex or complicated, as opposed to sending these off from the less experienced people after some time has elapsed to a decision review branch, which adds another three months or better to the process. If you took DRB out, you would end up with a time frame of six months. If you improved access, the photocopying of files and sending those out, to bring it down to a month or less, it would reduce the time frame even further.
This is at least one area where both communities agree. You will hear workers saying: "We don't want it to take so long. We want to be able to get a file more quickly." You have employers saying exactly the same thing: "We want to get access more quickly. We want decisions made more quickly." What the employers are asking for is simply for a fair, proper adjudication of a claim, not something quick that misses things and ends up sitting in an appeal system, but something that is done as accurately as possible. So it is not for taking something away that is of benefit to workers, such as DRB, or for employers. It is for leaving the decisions in the hands of those individuals most experienced to render proper adjudication.
The Chair: The last question, very briefly, is from Mr Ramsay.
Mr Ramsay: I just wanted to follow up on that and ask, has that recommendation been put forward to the board?
Mr Ford: We have made that recommendation to the board. We also made the same recommendation to the standing committee, when we were last here, as a service issue. Following up from what my director said, with an operational review looking at these things as a customer service strategy, how to improve it overall, that would be one item to look at. I would not want to sort of play on the decision review branch and miss out.
Mr Ramsay: Have you any received response to that proposal?
Mr Ford: Not a formal response, no.
The Chair: Thank you very much. We appreciate your coming. I am sure you are looking forward to the report that is prepared. So are we. You will be among the first to know. Thank you for your time this afternoon. We appreciate it.
EMPLOYERS' COUNCIL ON WORKERS' COMPENSATION
The Chair: The next group appearing before us is the Employers' Council on Workers' Compensation.
I should remind people that there is coffee and milk and juice here. Please come on up and pour yourself one or the other, if you wish. Those people who are waiting for their presentation, have a coffee or a juice or a milk. It is about the only thing you are going to get from the government this year. It is a recession. I am sorry.
Would you please identify yourselves and then proceed with your presentation.
Mrs Andrew: My name is Judith Andrew. I am the vice-chair of the Employers' Council on Workers' Compensation. The chair, Jim Yarrow, unfortunately was unable to be with us today. I am here as a member of the executive of the ECWC. I am also with the Canadian Federation of Independent Business.
On my right is John Blogg, with the Ontario Mining Association. To my immediate left is Les Liversidge, with L.A. Liversidge and Associates. To Les's left is David Frame, with the Council of Ontario Construction Associations.
If it pleases the committee, Mr Chairman, I would like to read a short statement into the record. The statement is reproduced in the kits members have.
The Employers' Council on Workers' Compensation is an umbrella group of over 20 employer industry associations plus major employers and technical experts who work through the council to discuss, research and advocate positions on workers' compensation issues. Together we represent in excess of 80,000 firms in the province of Ontario which are concerned about the operations of the WCB. By acting as a forum for industry trade associations active on this issue, the ECWC develops united employer positions. The full list of our membership is detailed in the kit you have, and you will find it at the side of each of the various newsletters that are in the left-hand pocket of your kit.
ECWC has appeared on numerous occasions before this committee on behalf of our members. In addition to being active on issues contained in Bill 101 in 1984 and Bill 162 in 1989 the council has also made presentations to the resources development committee to assist in the review of the annual reports of the WCB. The last such review was in 1988 to review the 1987 annual report. You are well aware that the board is accountable to workers, employers and, through the minister and this committee, to the Legislature for the overall operation of the system.
Accordingly, we believe that the exclusive focus in these limited hearings on service delivery, while somewhat helpful, misses the mark in providing the necessary system analysis and appropriate solutions for the problems plaguing the WCB.
Nevertheless, you have invited us today to outline our perspective on the service levels to our members at the WCB. Without doubt, in too many cases, the service which has been forthcoming from the board, not just now but over many years, has ranged from inadequate to totally unacceptable. At this point, however, with a brand-new senior administration in place, there is little purpose in reviewing history and/or assigning blame. Instead, we propose to outline some of the underlying reasons for the deficiencies in service and leave you with recommendations as to how the situation could and should be improved.
We want to clarify that we have high expectations of the new administration because, very simply, our members need prompt accurate replies to their correspondence and telephone questions and concerns.
We recognize that service is the delivery end of a multiple of functions of the WCB. It is crucial to examine the board in a holistic manner to be able to recommend improvements in the system. Most significantly, the whole of the WCB has been under severe strain beginning with the passage of Bill 101 in 1984. The system has experienced massive change and change is still ongoing. Allow me to list some of the most significant changes which have tested the system during the past seven years.
In 1985, Bill 101: creation of the Workers' Compensation Appeals Tribunal, the board of directors, the industrial diseases standards panel and the offices of the worker adviser and employer adviser.
In 1986: a complete overhaul of WCB senior management positions and the creation of three vice-presidential positions.
In 1987: complete overhaul of the service delivery systems and new management roles at all levels.
In 1989, strategies: vocational rehabilitation, medical and claims adjudication strategies.
In 1990, Bill 162: introduction of overhauled benefits and pension system and the recreation of seven divisions with seven vice-presidents.
The net result of all these changes is that the board that existed in 1984 has changed dramatically. The total revamping of the internal systems alone caused considerable upheaval, and when coupled with major changes in legislative responsibilities, the breadth of these new responsibilities has given little or no time to settle into a mode of providing expected levels of service. These levels will most quickly be met if a moratorium is placed on the development and implementation of new strategic and operational policies. Obviously, there may be some limited exceptions to the moratorium but the brakes should be applied.
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Time is necessary to allow staff to grapple with those policies currently in the mix. Employee training is also vital to ensure that policies are well understood and applied fairly and consistently. Additionally, wholesale organization structure and personnel change at the board must halt, and technical changes already under way must be permitted sufficient time to jell. The administrators of the system need time to catch their breath on all of these fronts in order to deliver acceptable service.
Legislators must not forget that the costs of the WCB system are currently at a point of threatening its sustainability. Perusal of our July 1990 newsletter commentary shows clearly that cost trends are extremely worrisome. I will refer you to our newsletters. July 1990 is the last one in the left-hand pocket, and it is the back of that newsletter. We have also included in your kits a blowup of a particular graph that shows fairly dramatic costs associated in 1988 constant dollars with roughly the same number of accidents as took place in 1978. In other words, the number of incidents did not increase much from 1978 to 1988 over that decade, but the costs went up 153% over that same decade. So we have ballooning costs in the system that are just not producing satisfaction for anyone.
The lesson from past experience is that one cannot simply throw money at a problem and expect it to go away. The system's costs are running out of control while the levels of dissatisfaction with the system have increased at an equivalent rate.
We believe it would be appropriate at this time, under a new government, a new chair and a new vice-chair, to undertake a complete assessment of the board's financial and service operations in the form of a value-for-money audit by the Provincial Auditor. Such an audit would be invaluable for the administrators of the board in formulating their plans, and of course for the minister in carrying out his role of overseeing the productive development of its resources.
I will refer you to another item in your kit. It is one page, on the right-hand side, entitled "Requests for Value-for-Money Audit on WCB by the Ontario Provincial Auditor." In this we make the case that this is an important step to take in terms of achieving a higher standard of accountability to the board's stakeholders.
Mr Chairman and members of the committee, we have presented you with important recommendations today. I hope we now have some time to pursue in detail your questions concerning these proposals.
Mr Offer: Thank you very much for your presentation. I obviously have not had time to look through all of the documentation, but certainly look forward to doing that in the next while.
I understand your position dealing with the fundamental change that has gone on with the WCB system. I think what you are saying is let's just stop and let everyone who is there work through some of these different policies, this framework, so we can maximize efficiency instead of continually putting on a new fold of change so that everyone steps back and tries to regain.
If that is the position, and I understand that and certainly have a great deal of sympathy for it, you might want to expand on why you would want a value-for-money audit at the same time, when you are asking the system to just stop in terms of reform and get used to the system and work out all the kinks in the area. I wonder if that type of request -- again, one which I am not opposed to -- might not be more informative if the board were able to do exactly what you have asked, and then possibly a year or so down the line look again at the value-for-money audit.
Mrs Andrew: I do not really understand your contention that a value-for-money audit would somehow prevent the board from actually consolidating the change it has had up until this time. It seems to us that in the past change happened very quickly. It happened, I think, out of a concern to do something good for the system, but the outcome was rather unfortunate.
Our position in terms of this value-for-money audit is to ensure that any future changes are well thought out. Just overhauling systems and organization structure and all of those things tends to be very destabilizing for an organization. You need to think very carefully before you take these steps, because it has an effect on the staff at the board and the way they perceive their roles, whether they feel they are threatened in some way. That in turn has an incredible impact on how they deal with the clientele. There have been periods of time when the staff have practically barked over the phone at some of our members, because they are just unhappy.
We are arguing that we take time now to assess where we are at and have the Provincial Auditor in to do this value-for-money audit, because we feel there are considerable dollars in the system and it ought to be able to service the employers and the employees somewhat better than it does now.
Mr Offer: I know Mr Cleary has a question, but if I might, we are not at odds with this type of request. My question was just a matter of clarification -- I do not necessarily want to restate the question -- that a value-for-audit procedure might be very useful after a certain period of time has elapsed when there has been no new change in the system, and allowing all those within the system to get used to the system and maximize its efficiency. I recognize what you are saying.
Mrs Andrew: Timing might be an issue, but we really think the value-for-money audit is long overdue, because the system is taxing our members for considerable sums, yet they are not getting service. Many workers are not getting service, and levels of dissatisfaction are very high.
Mr Liversidge: Just to follow up on that point, since 1984-85, we really have experienced an unprecedented scope of change in the workers' compensation system. There have been three major amendments to the Workers' Compensation Act. Some would argue that parts were good, and some would argue that parts were not so good. There has been a massive restructuring, which we have highlighted briefly, of the actual administrative superstructure that is set to deliver those programs in that act. Again, some would argue some of that was good, some was not.
Actually, we have seen over the course of this five or six years a lot of good ideas germinate at the WCB, a lot of good processes put in place, and then very quickly move on to another one and another one, and another policy and another administrative approach. We think it is time to allow the system to set a bit and to allow for good management to take root, and to take a benefit from that.
We think the Provincial Auditor can assist that management process, as setting out the initial expectations. The Provincial Auditor's objective is to assist the Legislature in holding the government and its administrators accountable by reporting to the Legislature on the quality of the administration's stewardship of public funds. What we want to see is good management, and a means to measure that. Maybe in a few years an auditor's report should be done, but we also think one ought to be done now to see what the problems are as they exist right now with this very extensive type of audit the Provincial Auditor is capable of doing in a very unbiased way.
Mr Cleary: Our office has been under the impression that the system has improved considerably over the past number of years, and you partially touched on it and you referred to putting on the brakes. How long do you think those brakes should be applied? How many months to let the staff training, etc, settle?
Mrs Andrew: At least time to do the audit and give the administrators an opportunity to formulate whatever plans they may have for the future. I do not think they should leap in and make changes right away without having the necessary information at their fingertips, and we think the provincial value-for-money audit will provide some of those answers.
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Mr Cleary: You must have an idea how long that would take.
Mrs Andrew: It is a big job.
Mr Liversidge: There are an awful lot of loose ends at the WCB right now. There are an awful lot of immediate problems. There are some critical problems. I would think at the very least you would want to see a halt to the development and initiatives of certain new programs. We are not saying to stop all the initiatives under way; that is not what we are suggesting. We are saying to allow the initiatives under way to bear fruit. There are an awful lot of balls in the air right now and it takes a masterful juggler to keep them all going without dropping anything. I do not think we should throw a few more in.
Mr Arnott: Mrs Andrew, can you tell me to what extent the Provincial Auditor in the past has turned his gaze on the Workers' Compensation Board?
Mrs Andrew: To my knowledge, it has been strictly to examine the financial statements of the board.
Mr Arnott: Is that all?
Mr Frame: Judith, I think I have some information. I do not have it in front of me, but I believe it was in the earlier to mid 1980s the last time this sort of analysis was done.
Mrs Andrew: But not a value-for-money audit. That has never been done. To do that kind of thoroughgoing audit is a relatively new concept in terms of the Provincial Auditor anyway, but on a usual basis, they examine the accuracy of the financial statements.
Mr Liversidge: Actually, there was a call placed to the Office of the Provincial Auditor to ask, "Has this ever been done?" "No." "Well, why not?" "We have not been asked," I think was the answer. We are trying to encourage the committee and the board and the ministry to collectively ask.
Mr Jordan: I think you said there were approximately 300 cases ahead of each -- was that this group?
Mrs Andrew: That was the previous presentation. Was that about the case load?
Mr Jordan: Yes. How do you respond to that from your point of view?
Mrs Andrew: I really do not have the experience to know how many cases a case worker could handle, but it sounds as if they are overworked --
Mr Jordan: And the morale is low.
Mrs Andrew: -- and some of these things have to be examined. That is basically the position of our group.
Mr Jordan: What comes to my mind is that in the constituency office, if someone is having a difficult time getting correspondence returned or getting a call returned, then we assist him and we get very prompt attention to the matter.
Mrs Andrew: I think you are right. There are some firms that have actually contracted consultants to get assistance with their WCB cases, just to find out where the case is at, whether there is going to be rehabilitation and what is going to happen. It tends to happen that when someone phones, that file gets moved to the top of the pile and somebody else's file gets placed further down.
Mr Jordan: So it could be that a management study is required, or more staff.
Mrs Andrew: Yes, I think so. Now I am speaking for the small business sector. I represent the Canadian Federation of Independent Business in this coalition on workers' compensation. Small business people, of course, have not got the time and the opportunity to keep calling case workers, so their cases, I would expect, drop to the bottom of the pile fairly often.
Mr Liversidge: One very important observation is that -- I do not know, maybe it is but maybe it is not -- the solution to a case load of 300, which I think is a high number, probably twice what it should be --
Mr Jordan: I think so.
Mr Liversidge: The solution to that is the deployment of additional resources. Our position is that the solution to that is employment of better management, because if you look at the growth of the Workers' Compensation Board as an agency, it has pretty well doubled in 10 years. I would ask, have the service levels improved an equivalent portion? Obviously not, or this committee would not be sitting and examining the question.
Again, we return to trying to get a sense of the root cause of that. Why are the case loads so high and why are there so many appeals? Why are there so many inquiries? Why are there so many complaints? It would seem to me the answer is not to fast-track disputes but to eliminate disputes in the first instance.
Mr Dadamo: In the Windsor office, I have noticed some change in the last little bit and I have also had an opportunity to tour and to meet some people and to talk to some people and visit an area which I have never gone to. There has been some change, but I still have some difficulties with the system when people have to camp out in front of the office for two or three days in order to make a statement. I feel there are problems there.
If you could change a couple of aspects in terms of service immediately, what would a couple of those things be?
Mr Liversidge: Not so much changing things but simply applying some of the principles, the foundations of which have already been laid out. Windsor is a good example. Perhaps one of the reasons you have noticed an increase and improvement in the service levels in Windsor is that the Windsor area office has itself gone through a bit of structural change by importing what is known as the integrated service unit concept to case management.
This was a concept floated in the mid 1980s, 1986 and 1987, an idea that got the full support of this council. We thought, where there was a multidisciplinary, integrated approach to service delivery, nothing but benefit would come from that. The problem was whether there was an ability for that to take root, because layered on top of that you had almost daily, frankly, new policies, new procedures, new processes, and an individual can only absorb so much.
I think that is the problem. It is not so much a structural problem but just basic, sound management in allowing better training of the individuals to ensure they have the tools and the capabilities to do certain things, a capacity of the system to ensure that there is an upgrading type of approach of individuals and the most effective deployment of skills to task.
One thing that there is not an absence of in the Workers' Compensation Board is dedication. I think the employees of the board are committed. They certainly want to do a good job and they certainly try to do a good job, but if you do not give them the tools with which to fulfil their task, they cannot succeed.
Ms S. Murdock: This is to Mr Blogg and Mr Frame, because I am from Sudbury and I am very familiar with mining and with the construction industry. Both industries are high-risk, and I was wondering what your experience with the board in terms of your types of claims would be, speedwise and in terms of the kinds of benefits, etc. Do you represent workers? Does your organization -- I guess I am asking another question here -- act as an advocate for your group, or is it a one-time lobby group to try and change things at the board?
Mr Blogg: I will start first I guess, since you are from Sudbury. My group, the Ontario Mining Association, is an advocate for the employers to the Legislature.
Ms S. Murdock: Yes, I know.
Mr Blogg: What I do is try to assist our member Workers' Compensation Board specialists in dealing with their problems at the board. To answer your question directly, their main problem is time line in getting answers from the board. It just takes so long for them to get answers from the board, in part because of the case load and in part because of changes of adjudicators on claims. In the middle of a claim, you have a new adjudicator, and that causes some problems. As far as service delivery is concerned, that is where our members in Sudbury have the most difficulty in trying to get consistency within the adjudication branch, so that they can get quick decisions that are accurate and complete and concise. They may disagree with those decisions, but they can at least understand where they came from.
Mr Frame: I certainly agree with what John and Les have had to say on this. I do not need to repeat it, only to say that employers have a double function, not just working through the adjudication function but the revenue side as well, and the revenue side can be more onerous. It has not been updated like the adjudication system has been. It is in the process of being updated and there are plans to update it, but there are many problems related to the revenue side. I probably hear more problems related to revenue than to adjudication.
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Mr Waters: In your statement you gave us, you said at one point, "The system's costs are running out of control, while the levels of dissatisfaction with the system have increased at an equivalent rate." Can you expand on what exactly you mean? It is on page 4, the bottom of the first paragraph.
Mrs Andrew: Right. I was just going to direct you to some of the cost information that was contained in our July 1990 newsletter. It is on the back page of that newsletter. One of the charts there was blown up for you in the kit.
We had some actuarial analysis done on the costs of the workers' compensation system and we found some very telling things. The actual number of incidents that the board handles on a year-to-year basis has really increased less than 50,000 over 10 years, which is not a very large increase given the growth of the work force in Ontario, but the cost of handling those claims have gone up 153%.
We show here in pictorial form the unfunded liability and the whole financial structure of the board that shows the unfunded liability continuing to grow. That disturbs employers, because they know that even though they are paying something like 20% of their rates towards the unfunded liability, they are still on the hook for paying all of these costs which represent the difference between the board's assets and its liabilities, its obligations to pay compensation to injured workers. So that represents future assessment premiums to employers.
The third chart there shows the rate of increase of assessments. You can understand that if assessments had remained relatively level, the unfunded liability would grow because costs were going up, but the assessments have gone up quite dramatically as well. So employers are paying considerably more and we are still not paying the bills. From what we can tell by the various reports given to the Legislature and media reports and so on, workers are not pleased with this system, and certainly employers are not pleased with the system, so the statement on page 4 is to draw the comparison to the fact that although a lot of money has been pumped into this WCB system, it still is not satisfying anyone.
The Chair: The time unfortunately has expired. Thank you to the Employers' Council on Workers' Compensation. We appreciate your coming and the time you spent preparing this. You will undoubtedly be notified, as soon as it is available, of the report that is made.
If there is anybody who is having difficulty hearing what is being said, please say so and we can tell people to speak up. People who have just come in, have access to the coffee pot or juice or other beverages that are there.
ONTARIO FEDERATION OF LABOUR
The Chair: The next people we are going to discuss this matter with are the Ontario Federation of Labour. I would ask you to come up, have a seat, identify yourselves so that we know who is talking to us and present your material, if you can, within 10 or 15 minutes so we have time for discussion.
Does everybody have a copy of the submission? Good. Yes, sir.
Mr Paré: Like you say, I can introduce everybody. My name is Jim Paré and I am the director of organization services at the Ontario Federation of Labour. With me are Ralph Carnovale, a staff representative with the Canadian Union of Public Employees, Norm Carriere, a staff representative with the United Steelworkers of America, and Dennis Schweitzer with the United Transportation Union.
We have distributed this brief. I guess everybody has one.
On behalf of the 800,000 affiliated members of the Ontario Federation of Labour, I would like to thank the standing committee for input on the issue of workers' compensation service.
I would like to take a few minutes to touch on some problems that we see have some viable solutions, but we are not going to get into a lot of detail and we hope to get into some detail when we answer your questions.
One of the problems we see is the area of staff problems. Deep staff demoralization is pervasive at all levels, particularly among the front-line staff. Confusion, bitterness, cynicism and very high stress are the most common descriptions of the board's working environment. Most adjudicators feel their case loads are unmanageable. The technology they must use is unreliable and, in many cases, unsuitable to their tasks. Threats against board staff are more prevalent from people from outside the board than at any time in the past, necessitating special security measures.
Staff turnover is alarming. The average length of service of the board's claims and rehabilitation staff has dropped from around five years in 1987 to approximately 12 months at present. In Ottawa, for example, the average service of rehabilitation staff is about eight months.
There are some problems which can be found all across the province with regard to the servicing of injured workers, and we can break them down generally into basic operational problems and then we can break them down into the quality of decision-making.
Some operational problems include phones that are answered by machines and calls that are not returned promptly, letters neither acknowledged or eventually answered and lengthy delays in decision-making, especially on occupational disease cases. We will get to that later.
In the area of quality, it appears that the board is moving towards answering its calls and letters better. However, this seems to be at the expense of quality. Basically, instead of doing its own investigation of claims, the WCB expects the worker or the worker's rep to bring forward the evidence in more difficult situations. If this is not done, often the claim is deemed "abandoned."
Our solution to the problems in this area is that the board should provide prompt service and response to workers without sacrificing quality. The board should develop appropriate service standards, including standards for proper information gathering regarding claims. Answering machines should only be used after hours or for short work overload periods. The normal expectation should be that the phone is answered by a human being.
The key problem area we see is vocational rehabilitation. There is a broad-based consensus for the charge that injured workers are now receiving virtually no meaningful vocational rehabilitation. The board's rehabilitation strategy is a dismal failure and the early intervention requirements set out in Bill 162 are not being met or are being met with a single phone call, which is recorded as a section 54a contact.
Board figures put the average rehabilitation case worker load at just under 80 cases. This is 60% higher than the case load recommended by the Majesky-Minna task force on vocational rehabilitation.
The board appears to have adopted a tacit policy of returning injured workers to a job-ready state before cutting them loose, a policy which runs counter to the generally held belief that rehabilitation should mean returning workers to productive employment as nearly as possible to their pre-accident earnings and working conditions. Older workers have been systematically abandoned as "unlikely to benefit from a rehabilitation program" and thereby reduced to permanent poverty.
One of our solutions is that there should be some effective and swift bipartite consultation on a new approach to rehabilitation. This could include a study of existing practices and proposals for different ones. The worker's rehabilitation should be focused on long-term, dignified employment and not trapping the worker in various job ghettos.
Another problem area we see is claims adjudication. The adjudication strategy involved specialization of functions in adjudication, plus apparently centralization of some complex adjudication in Toronto. Overall, it seems to us that the quality of adjudication has suffered.
We believe this also needs some bipartite study and consultation. The key here is giving more responsibility and respect to the adjudicator's role and reducing specialization and fragmentation of the job. As stated previously, the turnover of adjudicators has been very high and morale has been very low. It is important the adjudicators be granted their democratic right to organize themselves in order that they can bargain for better working conditions. Adjudicators' independence will be enhanced with the security offered by the support of the rest of the bargaining unit when controversial decisions must be made. This security and the ability to address working condition issues, we believe, will lead to increased quality and impartiality in the decision-making process. It is imperative that WCB adjudicators be included in the Crown Employees Collective Bargaining Act, and that would take a legislative amendment.
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In the area of occupational disease, workers are dying and it is taking the WCB years to decide if the death is compensable. This is leaving hundreds of families not just grieving but suffering financially.
We believe the WCB must make a priority of occupational disease. This includes more resources to evaluate claims and studies, and strict time lines on making decisions on claims. The board must also add more diseases to the schedules, in particular mesothelioma, which was recommended by the Industrial Disease Standards Panel.
In general, the WCB was created in 1915 as a workers' compensation board. Over the years, the emphasis has shifted away, so that today workers are not respected or properly served.
It is important that legislation be passed formally creating a bipartite board, so that in the future, no matter what government is in power, fair policies will be bargained by the two stakeholders.
Finally, the labour movement is happy with the creation of the vice-chairs at the corporate board, the appointments of Odoardo Di Santo and Brian King, and the general direction towards trying to solve servicing problems, with less emphasis on policy development.
There is no question that legislative change is required to clean up some of the anti-worker sections of the bill, particularly the heinous deeming provisions of Bill 162, but noticeable progress has been made. We realize this government will likely have only one chance to reform the act and we look forward to input into the contents of the new bill. We hope it can be tabled by the fall, before many more injured workers and their families suffer under the provisions of the current act.
The Chair: Are there any other comments by other members of your panel before we get into questions? Brief ones, please.
Mr Carnovale: Speaking on behalf of CUPE, we very strongly recommend that the Crown Employees Collective Bargaining Act be amended to include the claims adjudicators in the bargaining unit, which is currently at the Workers' Compensation Board. To that end there was a letter sent to the Premier earlier this week by the present Ontario division, asking that such amendment be made as quickly as possible.
Mr Schweitzer: I represent railway workers throughout the province and I deal with all the regional offices plus the head office in Toronto. I would like the committee to know that in my opinion the head office in Toronto is too big. It is the most unwieldy and unmanageable of the board's offices, and the one that I find most difficult overall to deal with. It touches all of the areas, the service, the quality of adjudication, the time lags. Just the sheer size of it is intimidating.
Mr Carriere: I co-ordinate the Steelworkers' compensation. It represents about 80,000 workers and we have a number of full-time compensation officers. We have real concerns about how the compensation board, in terms of delays of claims and processing claims through the appeals procedure, seems to be deteriorating as opposed to improving.
There are a number of delays. There is the initial delay in phone calls, as we said in the statement about the answering service, which is just not acceptable; delays getting files which are requested and take three to four months; delays after your requests for appeals and you have to issue two or three letters; after you have had decisions, including the Workers' Compensation Appeals Tribunal, delays in getting the decision, if it is allowed, applied. People, old workers with probably a very short time to live, are waiting for this and nothing happens. We really have some concerns about the delays.
I was interested in what the panel before us spoke about, because I agree with what was said by the employers' council, that it is not a good idea to have a speedy or fast-track appeal system that does not work, but the way is to reduce the numbers. That is where we are at, and that falls strictly on the shoulders of those people who were making that comment. We are really in support of that one.
Mr Arnott: Getting back to the issue of service, I appreciated the comment about setting standards for response times, etc. When I call the Workers' Compensation Board and I am told someone will get back to me in 48 hours, I take it with a grain of salt. But they appear to have standards. To me, it almost seems that they have standards but they are not meeting their own standards. Would you concur with that?
Mr Carnovale: I think that, depending on which adjudicator you speak to and which office of the province you speak to, it can be anywhere between 24 and 72 hours, depending on what that individual does. One of the things we were kidding about is that we happen to leave our home phone numbers with people to make sure they get in touch with us, and we are getting phone calls at home at 10:30 at night at home, that kind of stuff. There appears to be no consistency to the application. Saying 48 hours is fine, but when it turns into five and six days later, the 48 hours is meaningless.
Mr Arnott: I certainly concur with your contention that there should be a human being at the end of the telephone line. I think it creates so much more frustration if there is not, if you are talking to an answering machine. There is no question about that.
Mr Paré: Especially if you are having difficulty making your mortgage payment.
Mr Arnott: The other question I have is that I am sure when the board comes in and talks about what it is doing to improve service levels later on in this exercise, it is going to tell us that a certain number of cases are handled without incident, without problem, 80% or 90%; I do not know what they will claim. To me, the ones that are not handled expediently that come to my office often involve a situation where, for example, if the worker was working along and got an injury -- he may be a very dedicated, hard-working guy -- he did not immediately report it to his supervisor. He went home that night and thought, "It is a little sore today, but hopefully it will be better tomorrow." He wanted to go into work the next day, so he did not go to the doctor immediately, that sort of thing. Then there is no what the board calls continuity or whatever the terminology is.
How can we better educate the workers before they are injured on how the board operates, so that they know they immediately have to report to their supervisor and immediately should seek medical attention?
Mr Paré: In unionized workplaces we certainly do our best to keep our members informed about the sort of time lines that are involved with the WCB. I do not know how you would change the system in an unorganized workplace. We cannot expect the board to be mailing out notices to every person who works in Ontario but I think, maybe through the employers' system, they continue to remind employers to let their workers know there are some time lines. Whether that would actually take place and whether that notification would happen would depend on the employer obviously.
Mr Jordan: I was interested in the regional office. What level of claim can they deal with, or can they?
Mr Schweitzer: All levels, except for the complex cases. Complex cases deal with things like heart attacks -- we are having amputations sent over to complex case units -- deaths. Regional offices can deal with everything else. In fact, in my opinion, the regional offices can deal with everything, but that is not the way they do it.
Mr Jordan: That is my question. Is the regional office passing it back to head office here in Toronto when it could be dealt with at the regional level?
Mr Schweitzer: No, I do not think that is so. I think they have criteria for what type of claim has to go to the complex case unit, and also there is something written for their own people in regard to a claim that is reopened or a claim that is delayed so long that it has to be shipped out. They have their criteria, whether we agree with it or not. I do not particularly agree with it. I will give you an example: An amputation in Sudbury within the last two weeks of one of our trained persons. It is a straightforward case. She was injured. The train ran over her leg. It is payable, no ifs, ands or buts, and they have a regional office right in Sudbury, yet they shipped it to complex cases. To me that is kind of silly.
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Mr Jordan: What about the employer? What type of follow-up does the employer do? It is his employee and he has been paying workers' compensation. Once the paper work is done and it has gone in, is there any follow-up by the employer?
Mr Schweitzer: How much time have you got? You want to talk about one of my particular employers, Canadian National Railways. They have been rated as the safest railway in North America. Their claims reporting leaves a lot to be desired. They are a federal employer; they are a schedule 2 employer. They do not believe that parts of the act pertain to them, like section 54b, the reinstatement part. We have all kinds of problems with them. They would like every injury to happen, to be allowed to be paid and get their worker back to work as would everybody, but I do not think their follow-up is the greatest.
Ms S. Murdock: In your presentation, there is one statement that I am hoping would not be misconstrued by anyone who would be likely to read it. It is on page 10 and it says, "We realize that this government will likely have only one chance to reform the act." I would not want anyone to think that this means we only have one term. I know you mean that we would probably amend any portion of the Workers' Compensation Act -- one sitting.
Mr Paré: I will always consider one sitting or one term as a government, hopefully --
Ms S. Murdock: No, you do not mean that.
Mr Paré: No, I do not mean that.
Ms S. Murdock: I did not think so. I just wanted to clarify it for the record.
The Chair: I am glad you got that cleared up before anybody else asks questions.
Mr Wood: First of all, I want to thank you for the presentation. It is a very good document. On page 8 you refer, under (c), to solutions. I am just wondering if I could get you to expand a little bit. You are talking about strict timetables on making decisions on claims. I would like to add a little to it. In the workplace I was in before I was elected as a member of Parliament, there was a 30-day period. If there was a disputed workers' compensation claim that lasted more than 30 days, then the sick leave kicked in and they could take as long as they wanted to appeal. There was no emergency in it. People were getting their pay. I am just wondering if you would expand on what you were just saying.
Mr Paré: In the workplace that I come from, you would get paid from day one because we had that arrangement in the collective agreement until they got paid, but in many places, especially non-union workplaces, those provisions do not exist, so the worker is out on the street waiting for a decision to be made on his case and there is no money. I do not know how many people in this room could go three or four months without any wages, whether they could continue to pay their mortgage. In the workplace you come from they had a 30-day kick-in. The one I come from started right away with a sickness and accident benefit plan, but in fact many workplaces do not have these kinds of provisions. So that is why we would like to see stricter timetables.
Mr Carriere: Let me follow that up. It is worse than that. That is where the question comes about industrial disease, whether the employee can take a chance, a risk, because most of the coverage workers have under an insurance program have that clause that says non-occupational accident. In a lot of those cases, workers who feel they have an industrial disease take sometimes two, three and four years to get determined. If they make a claim, the insurance company does not pay them because they are claiming it is an industrial disease. If that happens, there is zero money for that employee, for that worker, and it could be two or three years.
If he loses the claim at the comp, it is hard to come back on sickness and accident benefits because the medical is clear; he has a legitimate disease. He cannot get it while he is arguing comp because they claim it is industrial, that is what he is saying. If it takes four years to settle it and you lose, it was obviously insurable. By that time, most of those insurance people say that you have one year from the time they started to get your claim so that they are out.
Mr Klopp: With regard to the occupational disease again, if you are a worker, is this the same idea? If you are working at an asbestos mine and then you leave the asbestos mine and a few years later a doctor finds out you have lung cancer, is this part of this occupational disease thing? Because that is very frustrating. Not only people I know, but also good friends are going through this state right now and it is very frustrating. What time frames do you mean when you solution tight time frames? Do you have a number at all or just get it better, period, 30-days?
Mr Paré: We have not really sat down and put any specific time limits on it. What we would like to see is some more resources applied to the issue so that we can make the evaluations and make some decisions quickly.
Mr Klopp: This question has been around a long time.
Mr Paré: Ralph just wanted to say something.
Mr Carnovale: One of the things I think should be clear -- and with all due respect to the members around these tables -- is that maybe you should clean up your own backyard first. CUPE represents a number of crown employees and one of the biggest problems I have, and I negotiate on behalf of the Ontario Housing Corp, is that it only has six weeks. If WCB does not make a decision within six weeks, you have got to wait and you wait for as long as it takes. That is one of the bigger problems.
When you are looking at the kick-in times and whatever, start looking at your own crown agencies first, see what your own crown agencies are doing, and then go up and tell the rest of the employers in this province to follow suit. It is the old backyard syndrome, but unfortunately that is where you are falling down. You are falling down in there and you are also falling down in your modified work programs and reinstatements. You have got the worst record as crown agencies of any employer in this province.
Mr Dadamo: Very quickly, years ago I used to say that WCB here in Toronto was top heavy, nobody listened. Now I am an MPP and sitting on this board, I hope people will heed that.
I wanted to make more comments and I wanted to ask questions. I think that 60% of the work done in my Windsor office is workers' compensation. There is no question about that. I have called the adjudicator here in Toronto on two different occasions and told him who I was. He said he would call me back within 48 hours. There were no phone calls. What I am thinking is that the first impression is always the one that is long-lasting.
Maybe we should be pushing for them to get rid of this 48-hour business, because I do not think they call you back within 48 hours. Maybe they should be saying, "I will call you back in 7 to 10 days," or something. Do you think that maybe we should be hiring people to answer the telephone so that when someone is calling and he is hurting, he should have someone who is alive who can talk to him? Even if they cannot answer their damn questions, maybe they can refer you to somebody?
Mr Paré: That is exactly what we are saying.
Mr Waters: Training of adjudicators: I wanted to ask a question on that and whether there should be constant guidelines for adjudicators in dealing with cases, whether you feel the training is adequate.
Mr Paré: I will let Ralph take this because he worked at the board.
Mr Carnovale: I had the experience of having worked for the WCB for 14 years, including the claims adjudication position. I think the training has come a long way from what the training was in 1974 when I started, where we were handed a bunch of form 7s and told, "Here, adjudicate."
As I currently understand, there is about a 13-week training program at George Brown College here in Toronto and at Cambrian College, I believe, in Sudbury and some other areas. Training has come a long way. The difficulty is that you still have the mentality of saying, "All right, there is your desk," once the training is finished, "Go do it," without any concern, without any regard to saying: "Wait a minute. There is a fold-in period, there is a phase-in period here where we have to be able to sit down and look at the response we are getting."
There has to be a follow-up and I think that is one of the criteria that is missing. You cannot just put a person on a desk, hand him a computer and a phone and say: "Okay, you are an adjudicator. Now go adjudicate."
Mr Paré: The case load is very heavy, and you cannot expect quality decisions from people who are just handling too many cases.
The Chair: I am sorry, we have got to move on because time is fleeting.
Mr Cleary: I know the Chairman is in a big hurry anyway, but first of all I would like to thank you for your presentation and I must say that over a vast lot of years I have heard many of your concerns before. But I was under the impression over the last few years -- and I will strictly talk more about the east than anywhere else where we deal in my office, and it happens to be in the Cornwall area -- that we had felt things had improved a bit, not a lot but a bit. We just had a group in here a bit earlier and they had suggested that we just kind of put things on hold and let the system get organized a bit.
Now my question to you gentlemen is, if you had a wish list, what would your priorities be?
Mr Carnovale: I think the case load of the claims adjudicators must come down. The case load of the case workers-who I do not think should be called case workers; they should go back to being called rehabilitation counsellors, which is what they are-should come down and come down significantly, more than probably the claims adjudicators'. Those two things would be the two primary situations that I would want rectified first.
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Mr Schweitzer: One of the biggest frustrations I see that could be easily solved is the timely decisions and the response within the time frames they have set themselves. I deal full time with workers' comp and that is one of the biggest frustrations we have. Whether it is 48 or 24 or 6 weeks, as long as you tell me you are going to call me back with an answer, I expect you to call me back.
Mr Cleary: The gentleman had just said a bit earlier he gets called up till 10:30 at night. He is lucky that is as late as it is.
Mr Schweitzer: That happens regularly.
Mr Cleary: I know. Thank you.
Mr Carriere: That is simple. The worst is that workers who are entitled to compensation ought to receive their benefits within a reasonable amount of time, which I would say is about two weeks. It is as simple as that. It is criminal for workers to lose homes and property and have breakup of marriage and families when they have legitimate claims, because of the system.
So the wish list is that where they brag, "The majority of our cases are done reasonably well," is it something to be proud of that what you are supposed to do, you are doing with most? You say because of that, "Well, the little percentage -- that is okay." I think it should be 100%. It is a system. There may be one or two who fall off the track, so that you have to straighten it out.
We have all kinds of examples about what it is, and what happens in this case when workers do not get it. It is really that workers do not get any money and that is not acceptable. So the wish list is to pay everybody who is entitled to compensation.
I agree that the adjudicator has to be well-trained, that they have to cut down completely on the decision review board, a specialist program. We have an avenue there that the adjudicators, rather than really looking at it, just pass the buck. "I will let decision review look after it." All of that process of delaying where you are going to get claims does not help anybody. But the wish is to pay people who are entitled to comp within a reasonable time.
The Chair: You have been very helpful, as have the other groups. We have appreciated your attendance and the work in preparing the material. You will be getting, obviously, a copy of the report when it is prepared. Take care. Thanks for coming in.
UNION OF INJURED WORKERS
The Chair: Next is Mr Biggin, with the Union of Injured Workers. If you have people with you, please bring them up. Please tell us who you are and then proceed with your comments, perhaps 10 to 15 minutes, and then we will be able to discuss some of the issues that you raised.
Mr Biggin: My name is Phil Biggin and I am the executive director of the Union of Injured Workers. I have with me today the president of the Union of Injured Workers of Ontario, Francis Cuccia.
The Workers' Compensation Board was set up as a result of a study by Sir William Meredith prior to 1914. The basic idea that Justice Meredith came forward with was that the injured workers would have security of payment and, in return, they gave up the right to sue the employer. This was the historic compromise, but over the years we have seen this system eroded so that now we consider it to be an employers' compensation system.
The Union of Injured Workers was founded in the early 1970s by workers who wanted, essentially, to ensure that we return it to a system where workers are justly compensated. We called for either job security or full compensation. We called for automatic indexation of pensions. We called for abolishing the Workmen's Compensation Board doctors, whom we considered to have a conflict of interest, and we asked for stricter penalties to ensure that health and safety were administered in the workplace so that injuries would be reduced rather than increased.
Our organization is well known to you legislators. We have been very active throughout the years in all of the public hearings around workers' compensation. Our workers came to Queen's Park on 1 June 1983 to protest Professor Weiler's proposals, and at the time, the government was smart enough to set those proposals aside. We also came to the government after Bill 162 had been tabled in the Legislature and forced the government to hold public hearings.
Today we are here to talk about the service delivery at the Workers' Compensation Board. Our case load is extremely high and over the last couple of years, our case load has doubled. Part of the problem that we see at the compensation board is with primary adjudication.
But before I get into some of the specific problems that we have, I want to state that first of all we are very happy that the Premier has appointed a new chair and vice-chair at the compensation board. We see this as a very positive step. However, there are many people at the compensation board who we consider were responsible for the degeneration in services over the past five years in particular. These people are as responsible as Dr Alan Wolfson, who was dismissed and has gone his way. These people are still at the board and we feel very strongly that they will have a role to play which will not be in the interest of workers.
Primary adjudication: Over the last five years and in particular in the last year, there has been a dramatic increase in delays. In initial adjudication, where before a worker was able to get compensation within a matter of weeks, it now takes five to six months. If you have to go to decision review or to the hearings level, it takes another six months of delays. Even with the timely decision-making policy that was established in 1990, it is a 12-week period before a decision must be made. Can you imagine a worker and a worker's family waiting with no benefits for 12 weeks? We have many people in our organization who have been waiting for six, eight and 10 months before they get a positive decision from the board. When they get the positive decision, for many of them it is too late. It is too late because their families have been lost. It is too late because they have lost the mortgage on their home. These are real people whom we are dealing with.
Under Alan Wolfson's regime, the emphasis was on systems, and I have nothing against producing systems as long as the goal of those systems is to assist the people who are supposed to be assisted; in this case, the workers. It was after all, I would remind you, supposed to be a workers' compensation board.
One of the problems we see is transferring files from adjudicator to adjudicator to adjudicator. I have cases that are still going on where there have been six different adjudicators involved and sometimes more. Each time a new adjudicator gets the file, he has to review that file. Once it is sent to another adjudicator, you have to start all over again, and all the while the worker is waiting for benefits.
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Then you have the situation where the file is lost periodically, and this is a very common situation. You would not think it would be in an organization that has imaging, an organization that has the most sophisticated computers, an organization that has all sorts of fancy technology, but files get lost.
The latest thing that we are encountering is that the file has been sent to Downsview rehabilitation centre. Why is it sent to Downsview rehabilitation centre? It was sent back from the hearings branch because they said that the operational branch has to decide a couple of issues. In the meantime, the file was transferred to a couple of adjudicators and then, accidentally, sent out to Downsview. The delays go on and on and on, or the medical reviews.
I am very sympathetic to the staff at the Workers' Compensation Board. Many of the staff are fine, and over the last five years I have been disturbed to see some of the more experienced staff leaving the board in frustration, so that now we face a more inexperienced staff. I want to see a system develop whereby everybody wins; the staff get fair treatment and the workers get fair treatment. This is not the situation.
I have a case outstanding today where the person was brought in for a pension assessment. This is a very longstanding case and the doctor said, "I have reviewed the file and your pension is confirmed at the 10% level," even though 10 years earlier, another doctor at the board had said that he wanted to give an increase of 5% in the pension. When we went to see the pensions adjudicator, the pensions adjudicator said, without the file before him: "No. There is nothing in the file to warrant that."
We just had the case reopened and one of the most experienced adjudicators sent us a letter. The letter stated that the worker had had no complaints for the last 12 years. This worker had left the country on a couple of occasions. When you look at the file, the worker had been back two times on temporary total benefits. Now we have an adjudicator telling us that there is no evidence in the file that the worker had complained over the last 12 years, even though the last time that worker was on temporary benefits was in 1989.
I would like to see a board which is responsive to the needs of injured workers, makes timely decisions and gets benefits out to the workers. We do not want anybody to have a free ride. We are not asking that the person who may be fraudulent be given benefits. No, that is not what we are asking. We are asking that the workers who are entitled to the benefits get those benefits in a time when they can use them to bring bread and butter to their families' tables. This is not the situation right now. It is a disgrace.
I told Dr Alan Wolfson a year and a half ago: "We are not disputing the fine technology that you are bringing to the board. We are not disputing the restructuring that you are doing, the decentralization. But maybe you are doing too much, too fast."
I heard the employers say that they wanted a cooling-off period. That is fine with us, as long as that cooling-off period does not involve a tying-up of benefits. If we do not have the benefit services to injured workers improved, then we will resume the militant action that you saw from the Union of Injured Workers year after year after year until we got the automatic indexation of the permanent pensions in 1985, until we stopped the Tory government from putting forth Professor Weiler's proposals, until we forced Greg Sorbara and then Premier Peterson to hold public hearings by storming the Legislature. Our workers are angry, and justly and rightly so. If we do not see the changes, and significant changes, we are prepared to move again. But we are very optimistic that these changes will be forthcoming.
Mr Waters: Time lines have come up pretty well in every conversation we have had here this afternoon. Do you feel there should be actual written or spelled-out time lines for the different steps, going through the whole adjudication process?
Mr Biggin: Yes, I see no reason why, when the form 8 has been completed by the person's physician and the worker has made a report, benefits cannot go out even if the employer is objecting to the claim.
If the employer objects to the claim, it goes to investigations. Investigations is so burdened with case load -- the case loads at the board are phenomenal -- and investigations is so bad that it is a six-month delay. So our recommendation is that the time line should be extremely short. If the evidence is there, from one party or the other, unless the employer can produce evidence that there is something fraudulent, and really the onus is on it to do that, the benefits should be paid out immediately.
When I was on workers' compensation -- I was injured in 1974 -- I received my first cheque two weeks later. Why can we not have that kind of service delivery now?
Mr Waters: The decision review branch -- it has come up a couple of times about just abolishing it. What would your feeling be on that?
Mr Biggin: I am not in favour of abolishing levels of appeal because it is the opportunity that the person has if there is a difficulty. When you object to an adjudicator, claim adjudicator or pension adjudicator's decision, it goes first back to that adjudicator to reconsider and then goes on to decision review. In fact we could improve the training of the primary adjudicators to the degree that we would get the right decisions the first time, or better decisions the first time. The problem is now that you have to go to decision review to get bad decisions reversed and then, if those decisions are not reversed there, you go on to hearings.
There are an awful lot of mistakes made at the primary adjudication level and I think we have to look at that. I am not prepared to come out and call for the abolition of the decision review specialists until such times as the primary adjudication level has been addressed specifically. Anything that speeds up the worker getting benefits, yes.
Ms S. Murdock: First of all, I want to thank you for coming in, and yes, you have made your voices heard because 1 June has been declared Injured Workers Day, so I know there is a big demonstration here on Saturday.
Mr Biggin: We call it a celebration this year.
Ms S. Murdock: Demonstration or celebration, I will be there.
I wanted to ask -- and it has not been mentioned today but it is something that has been brought to my attention and I know that you advocate on behalf of workers -- what your experience has been with the assistants and the adjudicators and the difference between them.
Mr Biggin: The problem that I have and that people working with us have with the case worker assistants is -- well, for me it is a totally frustrating experience because you cannot get any specific information. Their job is to assist the adjudicator in collecting information. When I am calling the board, I want information, and so they refer me back to the adjudicator or they say I am going to have to get the file. If in fact the case worker assistants had the file before them, or had the facts before them and could have a discussion with you, it is fine.
I think the problem there is you are dealing with very inexperienced people. Again, many of the adjudicators we are dealing with today are extremely inexperienced because the old, experienced adjudicators have been driven, I would say -- and I do not think I am being unfair -- out of the board.The stress levels at the Workers' Compensation Board are absolutely amazing. I could not see myself working in the adjudication, in the operations level at the board. It is a very rigorous job and I have great sympathy for them, but many of the experienced adjudicators have been driven away, so we are faced with inexperienced people.
Now I guess we are seeing another phenomenon, which is people who are afraid to make decisions. They do not know what decisions to make, so no decisions get made. "It's better not to make a decision. It doesn't matter." Then, of course, they are protected because they have got the answering machine, which they do not answer for 24 to 48 hours.
I hate to say this, because I am a long-time trade unionist. I do not believe that I should have to go to a supervisor or a manager to get something that a rank-and-file worker should give me. But I get my results by going to the director of the ISU. It is a sad thing to say, but I think if we have a system whereby everybody goes and petitions the chairman or goes and petitions the directors, we have not got a system that is working.
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Mr Cleary: I would just like to thank you for your presentation and say that some of the questions have already been asked that I would have asked. I have a committee in my area and I work very closely with the injured workers. I attend their meetings, and we do have success. In fact, I am under the impression that in the last few years it has improved a bit in our part of eastern Ontario. We have a new gentleman we deal with in the Ottawa office and we are having some success. I will leave it at that.
Mr Biggin: Okay. I will answer you this way. I guess I would have a different interpretation of this. I know the groups you are working with in the east. The thing is that workers' compensation has become a growth industry. Because there are more problems, there are more people doing worker compensation now that there are more cases. And it is true. If you have somebody in an office, as you have in the Ottawa office -- we used to have, six years ago, counselling specialists at the Workers' Compensation Board. Those were specialized people who had a lot of experience. We could go to them and for sure they would solve the problem.
But I can tell you that I had two people in the last two years who were in the operations level who were appointed by the directors of the integrated service unit involved. Because they got sick of talking to me, they gave me a special worker in that section. I made the mistake of commending those workers to Bob Elgie and Alan Wolfson and they were taken out of the operations branch, which shows you the mentality we were dealing with last year and the years before.
I encourage the situation where groups that are advocating for injured workers have specialists dealing with their problems, somebody at the board who you can go in to. If it is a critical problem, they will get you a fast answer. If they cannot get it, they will go and find the person who is going to get the answer. That is the kind of situation I think you have there.
Mr Cleary: You are not going to tell anybody that we are having a bit of success there, are you?
Mr Biggin: I think it is good. With the Windsor office and the success you have had, we should praise people about that, because I think with the new administration they are not going to move people out of operations who are able to perform. Okay? We want to see people who perform and get the job done, and that means getting benefits to injured workers.
Mr Arnott: Mr Biggin, I want to thank you very much for coming in today and presenting your concerns. I certainly share very profoundly what you have said about the frustration when a file is transferred. A cynic might almost conclude that the paper is just being shuffled for the sake of shuffling it. I do not know why they do it, and the frequency with which the board seems to undertake that activity. As you say, you start at square one with each new adjudicator you get to. Do you have any idea why that seems to be the policy of the board?
Mr Biggin: If you want me to tell you why, injured workers started organizing and demonstrating in the early 1970s. The employers became much more sophisticated and they started organizing. There was a tremendous amount of pressure put on the board and the top administration of the board was more sensitive to the employers than it was to the concerns of injured workers, so that it really was in the interest of those people -- and there is no great conspiracy about this -- who wanted to make sure that benefits were not quickly gotten to injured workers. You did this by reorganizing, restructuring, moving people around. If you want to improve the benefits to injured workers, you restructure, to be sure, but you do not do it so that you are pulling the rug out from under everybody's feet. Not only the injured workers felt that way, but the adjudicators themselves. Even decision review specialists told me, "This place is impossible to work at right now," and this was two years ago.
We have to have a situation where the people who are adjudicating, making decisions on a specific claim, have the time to review it, and if they have an assistant, people are reviewing that and you are not switching it from person to person to person because you are so busy restructuring.
We are not against modernization and restructuring. We heartily support it. But do not do it in a way that is going to hurt the injured worker, and I think we can do that. I think we have some good people at the board now at the top who are committed to doing this, but we have to move right down through that structure -- not just because you have Odoardo Di Santo or Brian there, King. That is good, but you have to go step by step through the organization and give thorough training to sensitize all of the people at the board, sensitize them about the cultural diversity of our province, about the fact that when you have to go out and work on a construction site and struggle under unsafe conditions it is different than working in an office. You have to have the sensitivity that these are all people. It is a human problem, and that is what has been lost over the Wolfson years. It became a system problem and all of the solutions were system. The people, the workers, were forgotten.
The Chair: There are a couple of minutes, if anybody has any pithy comments.
Mr Wood: It is not really a question; it is a comment I want to make. I was listening to you very intently, and thank you for your presentation. Going back quite a few years ago when the compensation system was set up people would get paid but they would not have the right to sue.
Mr Biggin: That is right.
Mr Wood: Now you are saying that whole system has gone by the boards, and I guess in actuality it has, because I get very frustrated when I find out I have to use my staff in my constituency office appealing compensation claims or getting people to get welfare when my impression over the years always was that you are working and you get paid; if you are hurt, you get paid by compensation or you get paid by sick leave. You should not have to go to the welfare system to do it. It was basically a comment that I wanted to make. Thank you for your presentation.
Mr Biggin: That is a very important point, because the floodgates have been opened and there is a tremendous increase in case loads, but do not let people give you the idea it is just injured workers. The big problem at the board, and the employers should know this very well, is that some employers' advocates are contesting each and every case. They are going into Ford plants, GM plants and reopening all of the old cases. That is going to backlog the system. If we apply for a file, we have to wait eight to 12 weeks to get the file because you have so many people doing this.
We have to return this to its roots. It has to be a workers' compensation system, not an employers' compensation system.
Ms S. Murdock: This is just a comment rather than a question, because it is sort of interesting, particularly having listened now to four groups, two presentations from the employers' perspective and two thus far from the workers' perspective. I have in the past eight months, as parliamentary assistant to the Minister of Labour, learned fairly quickly that actually the complaints by both groups and both stakeholders are not much different. I mean, yes, there is the difference that they have in terms of whether benefits should apply or should not apply, but that aside, in terms of service problems at the board, the complaints are almost identical, and it is quite a statement to make. That is just my comment.
Mr Biggin: True, but I want to remind you it is a workers' compensation system.
Ms S. Murdock: Yes, do not worry.
The Chair: Anybody else?
Mr Arnott: I would just like to make one comment. I do not think anyone disputes that it is a workers' compensation system.
Mr Biggin: But it has not been operating in that way for the last five or so years.
Mr Arnott: I do not know of many employers who have been compensated by the system directly.
Ms S. Murdock: There are some employers who will accept peace offerings.
Mr Arnott: Okay.
The Chair: We appreciate your time and we appreciate the input. Take care.
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OFFICE OF THE WORKER ADVISER
The Chair: Office of the worker adviser, Ms Tait, Mr Halonen and Ms Melbye. Come on up and have a seat. I know who Mr Halonen is, but you could tell us who you are and spend 10 to 15 minutes, if that long, telling us what you would like to say and then the balance of the time we can spend discussing what you have raised.
Ms Tait: I am Rosemary Tait. I am the acting director at the office of the worker adviser. You have met Jorma Halonen, and this is Cara Melbye, who is a Mississauga office worker adviser. She has been with the organization for over five years. Jorma is the northern region manager, who has also been with the organization for the same amount of time.
We would like to thank the committee for the opportunity to make this presentation. I gather a number of other organizations have presented concerns that are similar to ours, so I am going to attempt to not be repetitious. I think you have a copy of our brief. I will try to highlight the areas that we feel are most problematic.
Perhaps, just to spend a second on why we are in a good position to give you some of our experience, over the last five years we have assisted in some manner over 20,000 injured workers a year, either through giving summary assistance, summary advice, or representation in appeals. On the basis of that, we are probably in a pretty good position to identify what are concerns in servicing with the system from both a worker perspective and a worker advocate perspective.
Just to provide a background, which other people probably have already done, in the past five years there have been a number of initiatives, both legislative and policy, at the board that are probably responsible for a lot of the servicing problems that have been talked about: two significant sets of legislative amendments in 1985 and 1989 and a number of policy development initiatives, partly driven by the establishment of the WCAT, which changed the policy development process at the board from a self-sufficient process to more of a precedent-driven process and a process that involves the public in a much greater way.
At the same time, the board was decentralizing its client services operations and was restructuring to integrated service units and was launching new medical and vocational rehabilitation strategies throughout this period, and concurrently introducing several technology innovations, including a new on-line benefits payment system, imaging and electronic mail and voice mail.
The board has an extremely ambitious reorganization plan that I think is responsible for a lot of the servicing problems that have resulted. Service improvements did come through this plan, and the most notable of those is decentralization. Without a doubt, our regional offices have echoed the service improvements that happen as a result of adjudication being done in the area where workers live. There is some role that the workers feel they can play in the management of their cases in general, and their doctors as well, so that is an improvement. But overall in the process of this enormous restructuring and reorganization, we feel very strongly that the board has been unable to maintain a satisfactory level of support for the primary adjudication function, very similar to what Mr Biggin said.
To their credit, the staff overall of the client services division have tried really hard to maintain adequate service levels despite the traumas that many of the staff were going through as a result of these changes, traumas like sudden job insecurity, relocation, unprecedented staff turnover, new policies, new payment systems, automation glitches, all of these problems that resulted from these innovations. However, many of the service impediments remain today and we would like to summarize what we think are the most serious problems. We are also attempting to propose some solutions that we hope the board will look at.
I guess the most dramatic problem is delays in adjudication. There has been a dramatic increase over the last few years in the amount of time it takes the boards to come up with initial decisions. For example, on the submission of a written objection to the operating levels of the board, the interval between submission of that objection and receipt of a decision in response to that has been consistently well over five months in the experience of most of our offices. That is the average time interval. The case-by-case time intervals are much more dramatic than that and we have had delays of well over a year to receive operating-level decisions from written objections.
Some of these problems are compounded by the board acknowledging receipt of correspondence. That is only done in a few cases these days. It seems to be extremely inconsistent.
When our staff inquire with the board about the status of a case, an objection that we have made, we often find that the objection has not even been assigned to an adjudicator until we finally get through to somebody and raise the status inquiry. It is not uncommon to find that action in response to an objection begins only after the case has been brought to the attention of the integrated service unit director, several reminder letters later.
Contrast this with the service response that we had come to expect in previous years. Usually, we used to get a letter acknowledging receipt of our objection within two to four weeks of submitting a written objection and a decision or answer to that letter within one to three months of submission. So it has been at least a doubling in average times, if not a much more dramatic problem than that.
As you probably know, the board has drafted and implemented a policy on timely decision-making. That was introduced this past November. There could well be service improvements coming out of that. However, in our belief, unless attention is paid to the underlying reasons for the delays, we are concerned that any service improvements attributable to that policy could well be offset by deterioration in quality of decisions. I will give you an idea why.
The timely decision policy seems to address only time lines. It does not look at aspects of the adjudication process that are not within the control of the decision-maker; for example, the time required for investigations, reviews by medical staff, the shortage of word processing support. Implementing a policy which requires that the adjudicator or decision review specialist get a decision out within a particular time that does not address things that are beyond the control of that person is not going to assist the process at all.
The overall solution has to accommodate the reasons for the delays. We think that a new adjudication support strategy is necessary. Perhaps it should include the following components.
Case loads have to be lowered. I am sure we are not the only ones who have identified this. It is our understanding that adjudicators carry somewhere between 200 and 400 cases at any time. None of us can understand how they could be expected to make well-considered and quality decisions in a reasonable amount of time with those kinds of case loads. We would also like to point out that in our experience lower case loads lead to faster turnover of cases generally and often fewer appeals, because the decision is right the first time around.
Staff turnover should be examined. We feel the experience level of adjudicators has decreased dramatically. The reasons for the high turnover should be examined by the board and corrective measures put into place to encourage staff to stay in their positions and gain experience. More training is required, including refresher sessions, case consultation sessions and improved strategies when there are new policy and legislative changes. We find that the operating level staff's ability to respond to new policy implementation is really slow. It is not uncommon for our staff to be aware of new policies before the adjudicators know about them. That is a serious problem with the delegation down of changes.
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We also would like to see some action on how files move around. We think the movement of files should be minimized. With experienced adjudicators, with more training in medical issues, with an overall greater degree of respect for the fact-finding process that adjudicators should be going through, we believe the number of occasions when a file has to leave the adjudicator to get another opinion or a review by somebody else could be dramatically reduced.
In looking at the adjudication problems, we feel strongly as well that the board should be consulting with the front-line staff. Adjudication staff know what is wrong with the process and they know what corrective measures they would like to make. They should be participating in the problem-solving process.
Finally, the stress management practices of the board should be reviewed. The work that these people do is really hard and it becomes a lot harder when people like us are expressing our dissatisfaction with their ability to turn the decisions out on a regular basis. An improved stress management strategy may be necessary, along with a look at the adjudication practices.
Communications are another aspect of the problem. The impact of these delays that I have just talked about is exacerbated by serious communications problems. Telephone calls are not answered. It used to be that the complaint was that no one answered the phone at all or that we just got caught waiting in sequence for several minutes only to have a message taken. With the innovation of voice mail, now the complaint is that we are able to leave a message but nobody returns the calls.
One feature of the voice mail system -- it is not really a servicing problem -- alarmed us when we realized what its implications were; that is, there is now a capacity for a caller to call in and key in a claim number and receive a status report. Staff of the office of the worker adviser have raised concerns with respect to privacy around this feature. It may be that it is secure, but we are not sure. We think the board should take a look at this and make sure privacy concerns are satisfied.
Again on communications, correspondence can be left for weeks without a response, as I said before, but on another level, much of the correspondence is not understood by injured workers, even those with reading skills in the language in which it is written. Injured workers are frequently seeking a representative just to get correspondence from the board explained in plain language. We have had people come in with a problem, with a decision that they thought was a problem, and it in fact allowed their claim but they were not able to tell from the language in the letter because it was overly bureaucratic and did not use plain language.
Overall, there is just a generalized lack of sensitivity to the importance of the role that injured workers must play in their own cases. This is manifested in several different ways. Entitlement denial decisions often state, with no apparent reasons, that statements of employers were preferred over statements of workers with respect to details or circumstances of an accident. We find that benefits are cut with little or no notice or explanation to the workers, and far too frequently injured workers report that decision-makers just do not have the time to listen to their complaints.
When you set this against the delays, communications problems diminish worker confidence in the system and increase the fear and insecurity that workers have, particularly in cases where benefits have not been paid at all because an initial entitlement decision is being waited for.
This has implications that go beyond the issue of initial entitlement. Permanently disabled workers who cannot be accommodated in their accident employment will have to rely on the board for rehabilitation into alternative employment. Successful rehabilitation depends in large measure on the establishment of a co-operative relationship between the worker and rehabilitation staff. The development of that relationship begins with the worker's first contacts with the board. We find that when the worker is not able to develop a good relationship with the board in general because of problems in initial adjudication, that has an adverse impact on the capacity for successful rehabilitation in the future. It is a problem that has a permanent impact.
We think a new communications strategy is needed. Some of these elements might be necessary:
The use of the voice mail system should be minimized. Ideally, we would love to see all the calls answered in person, but we also respect the need of adjudicators to book time off telephones to do the serious work on files that have to be done in order for them to arrive at decisions. However, wherever possible, in-person messages should be taken for adjudicators and strict rules for the use of voice mail, set in consultation with adjudication staff and support staff, should be put into place.
At a very minimum, all calls have to be returned. We have sometimes heard from the board that, "I've been trying to return the call but I can't find the worker at home." This could be a legitimate problem because all workers do not sit around all day waiting for that crucial call from the board. There is other business in people's lives. A suggestion we could make is that when the adjudicator has tried to return the call and been unsuccessful, perhaps the technology will support the dispatching of a very simple and brief letter, based on a form letter, which could acknowledge the worker's call, provide a brief status report and provide a most likely available time for the worker to try and call back if the letter does not satisfy the problem. Otherwise, telephone tag could go on for ages and nobody benefits from that.
The board should also, as I said before, ensure that the confidentiality of information is protected in the application of the voice mail system. Adjudicators should be given more support to explain their role and explain the decision-making process to workers. We find injured workers experience less anxiety if they know that a particular process is being followed and if they are given confidence that their concerns are going to be taken into account. Listening and explaining, more support has to be given for adjudicators to take the time to do that.
Plainer language is needed in correspondence. For example, if it is important to include information on the legislative or policy framework within which the decision is being made: Put it in an attachment to the letter. Provide adjudication staff with access to writing courses that emphasize the simplest form of making a statement. Have language and literacy specialists look at pamphlets and perhaps draft the standardized portion of correspondence so we can raise the ability of workers of understand their own cases. Again, involve the front-line staff in the formation of the communication strategy. This is really important.
We also see significant delays in scheduling of hearings. It is almost standard now for six months or more to go by between the request for a hearing and the actual taking place of the hearing. This is too long. The only thing we can think of here is that more hearing offices are needed. There is a little bit more detail in the brief about that.
The Chair: Can you speak about the complex case units, that there are too many cases being referred --
Ms Tait: I am about to, yes.
The Chair: -- and the occupational disease adjudication as an issue? Reference has been made to that by previous presenters today. We have to move on into the area of questioning now.
Ms Tait: Okay. I am happy with that.
Mr Ramsay: It seems the thrust of your presentation today is that adjudicators and others are overworked, that they have too high a case load, and that this is not only causing a slowness in the whole system but obviously stress to the people involved who are working at the board. Is it a matter of just more money, of hiring more people? There seems to be not enough people for the work that is there. What are the overall answers to the system? Is there just too much work for the people who are there at the board?
Ms Tait: That is a part of it. I think there are also ways to run things so that there is generally more support for adjudicators to do the job they have to do. Essentially what we are saying is if it costs more money to get it right up front, there could well be savings later on in the process. What we are proposing is more support for primary adjudication. There is a higher likelihood that the correct answer will be found right away and savings will be found later on in money that is now dedicated to appeal processes.
Mr Ramsay: Have you made these proposals to the board?
Ms Tait: Not recently.
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Mr Arnott: Have you any other suggestions as to how the adjudicator-to-case ratio might be minimized, aside from hiring new staff?
Ms Tait: Like I say, I think the operation has to be looked at, the way cases are assigned, the support that is given to adjudicate cases. Not having intimate knowledge of the operations, we cannot really say if it is just, "Add more money to the front line." In addition to adding more staff, to lowering the ratio, there are other efficiencies that might be able to be found if some of these things are looked at. But clearly, I think more people have to be added to the front line.
Ms Melbye: I have noticed that a lot of adjudicators do not have the policy manuals available at their desks, so they have to consult with someone else, and the policies are being interpreted by different people without reference to the actual policy. The board recently tried to revise its four- or five-manual set of policies and the result is a single volume, but it is much less helpful to adjudicate because it does not spell out exactly what they are to take into account. It has general principles, but they will still need to go consult with somebody else so that you find that there is a different policy in effect at the different levels of decision-making.
You really have to apply the same policy at the operating level in order to avoid all these appeals, the majority of which are successful. So let's get it right the first time. I think that would save an enormous amount of money for the board and you could invest that in more staff to do a better job in the first place.
Ms Tait: The faster turnover with better support for adjudicators and staff as well will offset and perhaps increase costs that might seem necessary at the front end.
Mr Arnott: I just want to thank you for your very constructive suggestions.
The Chair: If anything comes to mind, just let us know and you can interject later.
Ms S. Murdock: I am glad you made the point about the money because I know it costs the employer anywhere from $3,000 to $5,000 per hearing. When you think of the number of hearings that are done in this province, it is mind-boggling, and then forgetting those of the Workers' Compensation Appeals Tribunal, which are $5,000 to $10,000. So it is good to note that you can make the savings upfront.
But my question is on decentralization, actually. I know with decentralization, for instance, having the workers have more availability in their own bailiwicks was very beneficial, but there have been some complaints and I am hearing them again. I do not know how much validity they have in terms of the decision review branch being in the local regional offices and whether all the departments within the board should be decentralized or whether some should not be. For instance, the complex case unit is centralized. Should it be decentralized, etc? Comment.
Mr Halonen: Maybe I should answer that, since I am a regional manager. At least the report to me from my region is that decentralization has indeed improved adjudication at the DRB as well. I have not been an adviser before and having dealt with the centralized DRB as well as the regionalized DRB, there has definitely been an improvement in the first level of appeals through DRB, or DRS, decision review services, as it is now called, by regionalizing it.
Also, I think that within our brief, there is a recommendation with respect to the complex cases unit. There are different kinds of complex cases. It was our feeling that in many cases, the complex cases may well be better adjudicated decentrally provided that the technical support can be given centrally.
Presumably, with the imaging system the board now has, you could have a technical adviser talking to an adjudicator from one office to another having the same visual image in front of them and they could be discussing the case. Presumably that is possible as long as the file is visualized. In many cases, with the exception of maybe very complicated industrial disease cases where a number of these complex cases involve multiple injury types of situations and industries such as forestry or mining, it is our feeling that it is better adjudicated by people closer at hand to those industries and particularly in the north.
Ms S. Murdock: In relation to training, is it decentralization or centralization? When I first started working as a constituency assistant, it was centralized training for all the adjudication staff, and that has moved into decentralized. I found that there has been a difference in terms of decision-making depending on which region you went to. Sometimes the interpretation is just not safe.
Ms Tait: I think that for an organization like the board both might be a good idea. There are some issues where the kinds of training would lend themselves to local expertise being used. For example, in the kinds of cases that occur more often in the north, local training on how to handle those issues might be a good way of doing it, but perhaps there should be opportunities for centrally drafted and delivered policy training, for example, when new initiatives come out, it might have to be put together in the centre and sent out to the regions. I think an organization like this probably deserves a strategy that accommodates both of those ideas.
Mr Klopp: On page 13 and following on the top of page 14, the Industrial Disease Standards Panel recommended changes to the occupational disease adjudication process. How many times and when have they asked for these recommendations you have put in place? It said they have been asked for, but how long ago? Six months ago?
Ms Melbye: Easily a year and a half to two years ago.
Mr Klopp: Okay, and you feel very clearly that schedules 3 and 4 -- is it just a straight field where the board should just take some action and get them in there? Is it already in place, but they have not acted?
Ms Tait: With respect to those diseases, yes. We feel more that there are a lot of other diseases that lend themselves to use of the presumption, if the board would act and get them into the schedules.
Mr Klopp: Okay, thank you, I just wanted to make that clear.
Mr Wood: First of all, I want to thank you for your presentation. It is very well put together. A couple of things then, not really a question; I just want to make a few comments. The staff turnover I see you have covered very well on page 7, along with case loads and more training and then a review of the stress management practices.
Having lived in the north most of my life, I am just wondering if this ties in. Every once in a while we will pick up the newspaper and find out that somebody has not got any payment for compensation for quite a number of years and that person has taken his life. When they interview the family, they have threatened that if they would have had time, they would have taken some life on the worker's staff, I guess, who they felt was holding them back from getting their payments. I am wondering if the publicity on this is having a great effect on the workers. In the previous report they said staff only last about eight months in Ottawa.
It is really a comment. You do not have to answer, if you do not want. Being in the north, one example was a person who worked in the bush all his life and was moved to Ottawa. There are no trees to cut in Ottawa. There was very little education and the frustration after losing his house and his family and losing everything -- there was a statistic in the newspaper. I am sure that everybody who is looking after compensation claims has to be thinking about things of this kind that are happening and are covered in the Globe and Mail, the Toronto Star and these things.
Ms Tait: Yes, I am sure it has an impact.
Mr Waters: One of the things I have found since I became a member of the government is that everyone around here finds that our staff spend a vast amount of time chasing compensation, and I mean that quite literally and that is what it is, trying to track down these files and where they go. Does the WCB ever tell you where your file is off to? As an advocate for the workers, maybe you can answer that. If they do not, would it not be proper that they should?
Ms Tait: If you can connect with somebody on the phone and keep asking the questions in a polite manner that shows respect for the job that he or she is doing, yes, sometimes we find out what section of limbo the file is in and why. If you track it down, there usually is some sort of explanation, but often it has to do with something that we think could be minimized by giving the adjudicators more training and support. Do not have a system where every decision has to be vetted by three or four people, medical advisers, technical advisers, supervisors. Support the adjudicators, delegate more authority down to them to make the initial decision and the file is likely to be right where we think it should be, on the adjudicator's desk, waiting for him or her to be able to make the decision and pass it on.
Mr Waters: One more question is, if you have been sitting through some of the hearings, and I think I have asked it a couple of times now because it has come up, is, do you think there should be a set of definite time lines? You have now put a claim before the board and within so many days you should have at least an acknowledgement. Do you think there should be anything like that?
Ms Tait: We are a little nervous about them for the reasons I looked at earlier. If the time lines do not allow for the kind of work that has to be done to come up with the right decision, then by themselves the time lines will not solve the problem. It is not going to help if adjudicators are required to make a decision, and yet the investigation department has not been able to come up with the answers to the questions it has identified as key to supporting the decision. So we are a little nervous about the idea of a timely decision-making policy which does not accommodate their evidence- and fact-gathering needs. Combined with the adjudication support method that respects that they have to find this information in order to make the right decision, yes, there has to be some combination of those two things.
The Chair: Thank you for your time, for your preparation and for your co-operation. I want to thank Mr Di Santo, who has been here as a spectator throughout the afternoon and has obvious interest in what is being said here, and Mr King, the second new appointee. I want to thank the committee for its co-operation and assistance in making the afternoon run smoothly.
The committee adjourned at 1802.